Epidemiology of primary Merkel cell carcinoma in the United States

J Am Acad Dermatol. 2003 Nov;49(5):832-41. doi: 10.1016/s0190-9622(03)02108-x.


Background: Merkel cell carcinoma (MCC) is a rare, aggressive skin cancer.

Objective: We sought to describe primary MCC incidence trends, epidemiology, and predictors of survival.

Methods: The population covered by the Surveillance, Epidemiology, and End Results Program was analyzed as a prospective cohort. We measured age-adjusted incidence rates (per 100,000 person-years) and effect of age, anatomic site, and stage on survival.

Results: Incidence was higher in males (0.34) than in females (0.17). Cases (n = 1034) occurred mostly in whites (94%), in people older than 65 years (76%), and at the head (48%). The 5-year relative survival was 75%, 59%, and 25% for localized, regional, and distant MCC, respectively. Female sex, limb presentation, localized disease, and younger age were positive predictors of survival.

Conclusion: The highest incidence of MCC was observed in whites, males, and in people older than 65 years. Only 49% of cases were reported as localized. Better survival was associated with limb localization, early-stage disease, younger age, and female sex.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Merkel Cell / epidemiology*
  • Child
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prospective Studies
  • SEER Program
  • Skin Neoplasms / epidemiology*
  • Survival Rate
  • United States / epidemiology